Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China.
Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China.
BMC Cardiovasc Disord. 2020 Nov 10;20(1):479. doi: 10.1186/s12872-020-01758-w.
Coronavirus disease 2019 (COVID-19) has become a global pandemic. Studies showed COVID-19 affected not only the lung but also other organs. In this study, we aimed to explore the cardiac damage in patients with COVID-19.
We collected data of 100 patients diagnosed as severe type of COVID-19 from February 8 to April 10, 2020, including demographics, illness history, physical examination, laboratory test, and treatment. In-hospital mortality were observed. Cardiac damage was defined as plasma hypersensitive troponin I (hsTnI) over 34.2 pg/ml and/or N-terminal-pro brain natriuretic peptide (NTproBNP) above 450 pg/ml at the age < 50, above 900 pg/ml at the age < 75, or above 1800 pg/ml at the age ≥ 75.
The median age of the patients was 62.0 years old. 69 (69.0%) had comorbidities, mainly presenting hypertension, diabetes, and cardiovascular disease. Fever (69 [69.0%]), cough (63 [63.0%]), chest distress (13 [13.0%]), and fatigue (12 [12.0%]) were the common initial symptoms. Cardiac damage occurred in 25 patients. In the subgroups, hsTnI was significantly higher in elder patients (≥ 60 years) than in the young (median [IQR], 5.2 [2.2-12.8] vs. 1.9 [1.9-6.2], p = 0.018) and was higher in men than in women (4.2 [1.9-12.8] vs. 2.9 [1.9-7.4], p = 0.018). The prevalence of increased NTproBNP was significantly higher in men than in women (32.1% vs. 9.1%, p = 0.006), but was similar between the elder and young patients (20.0% vs. 25.0%, p = 0.554). After multivariable analysis, male and hypertension were the risk factors of cardiac damage. The mortality was 4.0%.
Cardiac damage exists in patients with the severe type of COVID-19, especially in male patients with hypertension. Clinicians should pay more attention to cardiac damage.
2019 年冠状病毒病（COVID-19）已成为全球性大流行。研究表明，COVID-19 不仅影响肺部，还影响其他器官。本研究旨在探讨 COVID-19 患者的心脏损伤。
我们收集了 2020 年 2 月 8 日至 4 月 10 日期间 100 例被诊断为重症 COVID-19 的患者的数据，包括人口统计学、病史、体格检查、实验室检查和治疗。观察住院死亡率。心脏损伤定义为血浆高敏肌钙蛋白 I（hsTnI）>34.2pg/ml 和/或 N 末端脑利钠肽前体（NTproBNP）<50 岁时>450pg/ml，<75 岁时>900pg/ml，或≥75 岁时>1800pg/ml。
患者的中位年龄为 62.0 岁。69 例（69.0%）有合并症，主要为高血压、糖尿病和心血管疾病。发热（69 例[69.0%]）、咳嗽（63 例[63.0%]）、胸闷（13 例[13.0%]）和乏力（12 例[12.0%]）是常见的首发症状。25 例患者发生心脏损伤。在亚组中，≥60 岁的老年患者 hsTnI 明显高于年轻患者（中位数[IQR]，5.2[2.2-12.8]比 1.9[1.9-6.2]，p=0.018），男性明显高于女性（4.2[1.9-12.8]比 2.9[1.9-7.4]，p=0.018）。男性 NTproBNP 升高的发生率明显高于女性（32.1%比 9.1%，p=0.006），但老年患者与年轻患者相似（20.0%比 25.0%，p=0.554）。多变量分析后，男性和高血压是心脏损伤的危险因素。死亡率为 4.0%。
重症 COVID-19 患者存在心脏损伤，尤其是男性合并高血压的患者。临床医生应更加关注心脏损伤。
